Sensory nerve action potentials and sensory perception in women with arthritis of the hand.

BACKGROUND: Arthritis of the hand can limit a person's ability to perform daily activities. Whether or not sensory deficits contribute to the disability in this population remains unknown. The primary purpose of this study was to determine if women with osteoarthritis (OA) or rheumatoid arthritis (RA) of the hand have sensory impairments. METHODS: Sensory function in the dominant hand of women with hand OA or RA and healthy women was evaluated by measuring sensory nerve action potentials (SNAPs) from the median, ulnar and radial nerves, sensory mapping (SM), and vibratory and current perception thresholds (VPT and CPT, respectively) of the second and fifth digits. RESULTS: All SNAP amplitudes were significantly lower for the hand OA and hand RA groups compared with the healthy group (p < 0.05). No group differences were found for SNAP conduction velocities, SM, VPT, and CPT. DISCUSSION: We propose, based on these findings, that women with hand OA or RA may have axonal loss of sensory fibers in the median, ulnar and radial nerves. Less apparent were losses in conduction speed or sensory perception.

Teaching social accountability by making the links: qualitative evaluation of student experiences in a service-learning project.

BACKGROUND: Many medical students come into medicine with altruistic motives; few carry this altruism into their practice. As a result rural, remote and international areas are underserved by the medical community. Teaching social accountability may help students remain altruistic and encourage work in underserved areas. Making The Links (MTL) is a project designed to teach medical students the social aspects of medicine via service-learning. AIMS: The purpose of the study was to explore student reflections on their experiences during the MTL program. METHODS: Qualitative data analysis was conducted using structured open-ended written questionnaires. Fourteen students, representing three student cohorts, participated in the study. Data was collected between 2005 and 2007. RESULTS: Six themes emerged from qualitative data analysis. (1) relationships, (2) social determinants of health in real life, (3) community development, (4) interdisciplinarity, (5) linking health and communities, and (6) personal learning. Themes reflected the opportunities and challenges experienced by the students during the MTL project. Students reported that MTL was an essential component of their medical training. CONCLUSIONS: MTL is a promising model for using service-learning to teach social accountability in medical training.